The Syndrome of Hyperlexia: Remediation Techniques

Philips Kupperman
Sally Bligh

Center for Speech and Language Disorders
479 Spring Rd., Elmhurst. II. 60126
(708)530-8551

General Principles of Speech and Language Therapy with Children with the Syndrome of Hyperlexia

1. Use written and visual models.
2. Use patterned language.
3. Use open ended sentences.
4. Generate Rules.
5. Use examples rather than explanations.
6. Use rote learning.
7. Teach one way, then reverse the procedure.
8. Teach specific pragmatic rules.
9. Use parents a co-therapists.

These general principles are applied to specific language learning objectives in therapy.

Specific Language Intervention Techniques

Use written and modeled patterned language to request and label.

• Model pattern then model changes.
• Work on receptive and expressive language together by reversing roles.

Expand labels (objects and actions).

Expand speaking situations (pragmatics and use).

• Use learned phrases in many contexts.
• Specifically teach how to adapt phrases to each situation.

Teach specific language concepts.

• Response to question forms (wh-, yes/no, inverted sentences)
• Asking of question forms (including wh-, yes/no, inverted sentences, and requests for clarificatoin, repetition or information)
• Verbs, prepositions, pronouns, plurals, tense, negation
• Maiking associations (What goes with; categories; same/different; how are they the same/different; what does not belong.)
• Cause/effect, consequences (if/then), what if.....
• Sequences (first/next/last, before/after, temporal words)
• Attributes and descriptors
• Multiple meanings, analogies, idioms
• Making choices

Teach how to explain/describe.

• "I'm thinking of ......" games
• "Barrier" games

Create narratives and dialogues (dictated, written and verbal).

• Dictate a story (correct the sentences)
• Write a puppet Show
• Create pretend play

Teach how to argue and tattle.

• Model and write the specific phrases
• Role play

Practice rules of conversation. (Write specific rules) For example:

• If someone speaks to you, you must answer.
• Say what you are going to do before you do it.
• Pay attention to the other person. (Don't fiddle with objects, scratch or yawn.)
• Give feedback. (eye contact, body language & comments)
• Stay on the topic.
• If you want to change the topic, say: "Do you know what?" or "Did you hear about....?"
• Check that the listener understands and is interested.
• Once is enough.

Language for Behavioral Intervention

Children with the syndrome of hyperlexia have difficulty listening, complying with rules and interacting with their peers. These children tend to to be aloof from other childrensince they do not know what to say to facilitate interactions. They have trouble listening to group instruction and frequently do not understand the explanations and reasons why certain rules exist. Because of this, these symptoms may resemble those of behavior disordered children, but actually the language disorder and unusual learning style is what is interfering with their ability to comply with rules. Indeed, standard behavioral interventions usually do not work with these children. We suggest that the teachers and parents:

1. Write behavioral rules.
2. Write sequence of activities to aid in transitions.
3. Write and model appropriate things for the child to say.
4. Use a positive reward system. (Punishment generally doesn't work.)
5. Use if/then consequence pattern when this language form is learned.
6. Specifically teach flexibility.

Teaching Pragmatics and Social Use of Language

These children often have difficulty learning how to relate to their peers. Giving them specific dialogues to follow and helping them learn what to say within social situations is effective.

Set up dyad or small group.

Establish rules of conversation for the dyad or group.

Activities progress in the following hierarchy:

Therapist directed:

1. Structured board game.
2. Structured word game.
3. Structured physical activity.

Therapist assumes coaching role:

1. Children decid what to do.
2. Children explain rules to each other.
3. Children argue and negotiate.

Be aware of gender related issues.

Teach how to make friends and be a friend.